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General NPI Number Information
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NPI Number | 1891931887
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Entity Type | Individual
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Provider Name | SUSAN BELK THIESSEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 2825 RANDOLPH RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1018
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Country | US
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Telephone | 704-377-1647
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 32861 ANESTHESIA SERVICES - 5TH FLOOR SURGICAL TOWER
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City | CHARLOTTE
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State | NC
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Zip | 28232-2861
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Country | US
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Telephone | 704-355-8983
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Fax | 704-355-8994
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 132662
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License Number State | NC
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